Evidence-based treatment of chronic heart failure.

The past two decades have seen a knowledge explosion in the field of cardiovascular diseases, in general, and in the understanding of chronic heart failure (HF) as a complex neurohumoral syndrome in particular. A new staging system for chronic HF has been developed within the last decade to facilitate the evidence-based prescription of medications and medical devices for each of its four stages. The burden of care for patients with chronic HF is substantially provided in primary care settings. Primary care physicians need to understand the underlying pathophysiology of chronic HF, the elements of its evaluation and treatment by stage, and when referral is necessary.